| NPI | 1184708042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL R. LOY President 606-784-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6742) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 6742) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2011-04-14 |